The Affordable Care Act expanded health coverage to millions of Americans in 2014. Because more people had insurance to pay for healthcare services, demand and spending predictably went up more quickly.
Hospitals say they'll be grossly underpaid if the CMS moves forward with a proposal to base lab payments on what non-hospital labs are paid. That could lead to labs closing and beneficiaries losing access to tests, providers said.
The Senate took up a bill Wednesday to repeal parts of the Affordable Care Act and was expected to continue debating the legislation into Thursday night. The White House, meanwhile, formally signaled a veto.
Health insurers that sell Medicare Advantage plans are primed for bigger pay bumps in 2017. It's a preliminary sign that the days of stark payment cuts under the Affordable Care Act are all but over for the industry.
The CMS is standing behind the cut to inpatient pay rates under the two-midnight rule despite ongoing legal battles with hospitals over the reduction. That doesn't bode well for hospitals' efforts to persuade courts to reverse the cut, legal experts say.
Family physicians have reservations about their ability to thrive in the shift by Medicare and other payers to value-based payment models—and about whether the shift will deliver the promised benefits for patients.
Humana and several other insurers are pulling the plug by the end of the year on Medicare Advantage plans designed to serve people enrolled in both Medicare and Medicaid.
As more Americans gain Medicaid coverage, investing in a health plan is a potential lifeline for urban safety net systems. In Chicago, the Cook County Health and Hospitals System and its patients have both seen their health improve with CountyCare, the system's Medicaid managed-care plan.
UnitedHealth Group's announcement this month that it will consider exiting the insurance exchanges in 2017 because of sizable financial losses on its exchange business was the latest in a series of blows to the Affordable Care Act.
Cincinnati-based Mercy Health and Akron, Ohio-based Summa Health will jointly contract for accountable care with health plans under a newly created clinically integrated network with broad geographic reach in the state.
Medicaid agencies want federal officials to keep them in mind as they incorporate participation in alternative payment models with all types of payers into Medicare's reimbursement rates for physicians.
Federal prosecutors announced charges Tuesday against a former hospital CFO, two surgeons and two other defendants in a kickback scheme involving nearly $600 million in fraudulent claims for spinal surgeries in Southern California.